Symptoms:

• Breast development and impotence in men
• Depression
• Headache
• High blood pressure
• Round, red, and full face (moon face)
• Skin changes
  • Acne or other skin infections
  • Easy bruising
  • Purple streaks on the skin of the abdomen, thighs, and breasts
  • Thinning of the skin
• Stopping of menstruation in women
• Weight gain
  • Abdomen that sticks out and thin arms and legs
  • Collection of fat between the shoulders (buffalo hump)
• Weakened bones (osteoporosis)
• Weakness (often noticed when trying to stand up or to raise hand above head)

Patients with a cancerous adrenal tumor may also have symptoms of higher-than-normal male hormone (androgen) levels, including:

• Acne
• Excess hair in unusual parts of the body (in women)
• Scalp hair loss

Signs and tests:

Tests to confirm Cushing syndrome:

• 24-hour urine sample to measure the following:
  • Urine cortisol
  • Urine creatinine
• Dexamethasone suppression test
• Serum cortisol levels

Tests to determine cause:

• Abdominal CT
• ACTH
• High-dose dexamethasone suppression test

Other findings may include:

• High cholesterol
• High fasting glucose
• Low bone density, seen by dual x-ray absorptiometry (DEXA)
• Low serum potassium